Abstract
Background
Brief computerized programs that train less threatening interpretations (termed Cognitive Bias Modification for Interpretations, or CBM-I) can shift interpretation biases and subsequent anxiety symptoms. However, results have been inconsistent, particularly for studies conducted over the Internet.
Methods
The current exploratory study tests 13 variations of a single brief session of CBM-I, a non-CBM-I cognitive flexibility condition, a neutral condition, and a no task control condition in an analogue sample with moderate to severe anxiety.
Results
Results suggest that all conditions, except the neutral scenarios condition and the alternative way to improve cognitive flexibility, led to changes in interpretations (when compared to the no task control condition). Only conditions geared toward increasing imagery during CBM-I and targeting flexibility related to emotional material differed from the no task control condition on other post-training measures.
Conclusions
Presenting valenced interpretations of ambiguous information during brief CBM-I, regardless of the format, can lead to changes in interpretation bias. However, most conditions did not differ from the no task control condition on other post-training assessments (and differences that did occur may be due to chance). Future trials should consider further testing of CBM-I that targets flexibility related to emotional material, and should include an increased number of sessions and trials.
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Notes
Additional measures were included that are not discussed here, including assessments of imagery vividness and engagement with training scenarios. For more details, please contact the first author.
There were no differences in Cohen’s d comparing the analysis of all cases to complete cases for BBSIQ, positive RRT Change, or negative RRT Change. For ASSQ, the differences in Cohen’s d ranged from -0.05 to 0.13. For three conditions, 100% Positive, Imagery Only/Audio, and Implementation Intention, these small changes in effect size were enough to change the statistical significance of the finding, with the 95% confidence interval shifting from including zero to not including zero.
Thank you to an anonymous reviewer for suggesting this analysis.
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Acknowledgements
The authors would like to thank past and current members of the PACT lab for helpful suggestions and feedback. This study was supported by NIMH grants R01MH113752 and R34MH106770 awarded to Bethany Teachman. Note, B. Teachman has a significant financial interest in Project Implicit, Inc., which provided services in support of this project under contract with the University of Virginia.
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Shari A. Steinman, Nauder Namaky, Sarah L. Toton, Emily E. E. Meissel, Austin T. St. John, Nha-Han Pham, Alexandra Werntz, Tara L. Valladares, Eugenia I. Gorlin, Sarai Arbus, Miranda Beltzer, Alexandra Soroka, and Bethany A. Teachman declare that they have no conflict of interest.
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Steinman, S.A., Namaky, N., Toton, S.L. et al. Which Variations of a Brief Cognitive Bias Modification Session for Interpretations Lead to the Strongest Effects?. Cogn Ther Res 45, 367–382 (2021). https://doi.org/10.1007/s10608-020-10168-3
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DOI: https://doi.org/10.1007/s10608-020-10168-3